Psychoanalytic perspectives consider that object relations and deficits of self-structure play a significant role in the etiology of substance use disorders. However, despite the rich psychoanalytic literature addressing this issue, there is only a limited amount of research supportive of these approaches. This study aimed to illustrate a comprehensive picture of object-relational patterns and deficits affecting the self-structure of substance abusers. The research was conducted based on a qualitative method and the content analysis method of Graneheim and Lundman's approach, and 23 patients with substance use disorder participated in it. Finally, four themes were identified as follows: relational patterns, quality of representations, defense mechanisms, and filling an inner void.